US8273725B2 - Stable hyaluronan/steroid formulation - Google Patents

Stable hyaluronan/steroid formulation Download PDF

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Publication number
US8273725B2
US8273725B2 US12/556,869 US55686909A US8273725B2 US 8273725 B2 US8273725 B2 US 8273725B2 US 55686909 A US55686909 A US 55686909A US 8273725 B2 US8273725 B2 US 8273725B2
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composition
harc
heat
tah
steroid
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US12/556,869
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US20110059918A1 (en
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Grace Chang
Elizabeth Voschin
Li-Ping Yu
Eugene Skrabut
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Genzyme Corp
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Genzyme Corp
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Priority to US12/556,869 priority Critical patent/US8273725B2/en
Assigned to GENZYME CORPORATION reassignment GENZYME CORPORATION ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: SKRABUT, EUGENE, CHANG, GRACE, VOSCHIN, ELIZABETH, YU, Li-ping
Priority to JP2012528801A priority patent/JP6121717B2/ja
Priority to BR112012005423-6A priority patent/BR112012005423B1/pt
Priority to EP19186507.0A priority patent/EP3622820A1/en
Priority to PCT/US2010/044975 priority patent/WO2011031402A1/en
Priority to CN201080043915.0A priority patent/CN102573468B/zh
Priority to EP10815804.9A priority patent/EP2475251B1/en
Priority to MX2012002830A priority patent/MX2012002830A/es
Priority to ARP100103295A priority patent/AR078281A1/es
Publication of US20110059918A1 publication Critical patent/US20110059918A1/en
Priority to US13/593,026 priority patent/US8680073B2/en
Publication of US8273725B2 publication Critical patent/US8273725B2/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/58—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
    • A61K31/726—Glycosaminoglycans, i.e. mucopolysaccharides
    • A61K31/728—Hyaluronic acid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/36—Polysaccharides; Derivatives thereof, e.g. gums, starch, alginate, dextrin, hyaluronic acid, chitosan, inulin, agar or pectin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

  • This invention is in the general field of compositions and methods comprising hyaluronic acid (HA) or an HA-related component (collectively “HARC”), for example pharmaceutical compositions, devices and methods for treating various medical conditions.
  • HA hyaluronic acid
  • HAC HA-related component
  • Hyaluronic acid has many medical uses, and various HARCs have been developed.
  • HARC includes hyaluronic acid itself (including HA from living sources such as avian or bacterial sources), as well as hyaluronic acid salts and derivatives of the foregoing, including polymerized gels, cross-linked gels, and derivatized hyaluronic acid.
  • HARCs may be administered by themselves, for example to provide relief from arthritis. They also may be mixed with anti-inflammatory steroids.
  • Lyons US2006/0141049 discloses pharmaceutical compositions containing triamcinolone acetonide and hyaluronate. Yu et al., Osteoarthritis and Cartilage vol. 12, Supp. B, P350 at page S144 (2004) discloses an in vitro evaluation of hylan G-F 20 diluted with a corticosteroid (triamcinolone acetonide) suspension.
  • HARCs When used in a medical product HARCs typically are sterilized by heating, autoclaving, chemical treatment or filtration. Often it is important to maintain the viscoelastic properties of the HARC. Sterilization techniques may alter viscoelastic properties or make it difficult to control or maintain the stability of those properties. Sterilization may decrease the shelf life of the product.
  • HARCs are heat sterilized before forming a steroid/HARC mixture. Sterility of the final mixture may be achieved by filtration of the steroid solution before it is mixed with the HARC.
  • TAH triamcinolone hexacetonide
  • one aspect of the invention can be generally stated as a pharmaceutical composition
  • a pharmaceutical composition comprising in admixture a hyaluronic acid related component (HARC) and a pharmaceutically effective amount of triamcinolone hexacetonide (TAH).
  • HAC hyaluronic acid related component
  • TAH triamcinolone hexacetonide
  • the % change of one or more viscoelastic properties should be no more than ⁇ 10% as compared to the comparable change in the control HARC (without TAH);
  • the change in the composition pH should be no more than 0.5 pH unit;
  • the change in osmolarity should be less than 10% (more preferably less than 5%) different from the change in osmolarity of the control HARC;
  • the steroid should retain at least 90% (more preferably at least 95%) of its chemical integrity—i.e., there is less than 10% (more preferably less than 5%) chemical degradation—as determined by recovery data. Examples of suitable protocols for shelf-life and other tests are provided below.
  • the composition can be heat sterilized.
  • the composition is stable in a simulated autoclave conditions with approximate 30 F o , in which the composition is heated at 121° C. for 30 min in a oil bath.
  • the % change of G′, viscosity ( ⁇ ) or phase angle ( ⁇ ) should be no more than 20% different (more preferably no more than 15% different) from the control (HARC without TAH);
  • the HARC component includes both a cross-linked HARC gel and an HARC fluid component.
  • the combination has a gel:fluid ratio between 80% and 20%, more preferably between 65% and 35%.
  • HARCs may be used, including Orthovisc®, MonoviseTM, CingalTM, and ElevessTM dermal filler (all from Anika Therapeutics), Adant, Arthrease, Arthrum, Durolane, Fermathron, Go-on, Hya-ject, Hyalgan/Hyalart, Hyalubrix, Hy-GAG, Ostenil, Sinovial, Supartz/Artz, Suplasyn, Synochrom, Viscorneal, Enflcxxa, and Gel-co.
  • Orthovisc® MonoviseTM
  • CingalTM CingalTM
  • ElevessTM dermal filler all from Anika Therapeutics
  • Adant Adant
  • Arthrease Arthrum
  • Durolane Fermathron
  • Go-on Hya-ject
  • Hyalgan/Hyalart Hyalubrix
  • Hy-GAG Hy-GAG
  • Ostenil Sinovial
  • Supartz/Artz Suplasyn
  • one ml of the composition includes at least 5 mg HA, when measured by standard procedures such as acid degradation followed by a determination of the HA free acid.
  • the composition has a viscosity and an extrusion force that enable its use in a syringe. For example, it is delivered from a 5 cc syringe with a needle size of 20 G-1.5′′ with an extrusion force of less than 30 Newtons.
  • the viscosity is between 20 Pas and 100 Pas.
  • the gel component may be divinyl sulfone (DVS) cross-linked hyaluronic acid.
  • DVD divinyl sulfone
  • composition may be packaged in a syringe for delivery to a patient and it has a sterility assurance level (SAL) suitable for human administration.
  • SAL sterility assurance level
  • the composition includes a surfactant, such as Polysorbate 80, Polysorbate 20, Pluronic F-127, Pluronic F-68 or other physiologically suitable surfactants.
  • a surfactant such as Polysorbate 80, Polysorbate 20, Pluronic F-127, Pluronic F-68 or other physiologically suitable surfactants.
  • the stability provided by the invention enables a longer shelf life at room temperature so that the mixture may be stored after heat sterilization.
  • the sterilized mixture can be packaged and stored (e.g., in a syringe) for later use.
  • another aspect of the invention features a package containing a syringe filled with the sterilized pharmaceutical composition.
  • the invention also provides more efficient manufacturing methods, and another aspect of the invention can be generally stated as a method of making the above described sterilized pharmaceutical composition by mixing the HARC with the TAH, and subjecting the mixture to heat sterilization. The sterilized mixture is then stored under sterile conditions.
  • the invention may be used in a method of treating a patient for joint disease by using the syringe to administer the pharmaceutical composition into a joint of the patient.
  • Administration may be by standard injection, by introduction on-site during arthroscopic surgery or open-knee surgery.
  • FIG. 1 shows the structure of TAH.
  • FIGS. 2 a and 2 b plot the change in elastic modulus after an accelerated shelf-life test ( 2 a ) and after sterilization ( 2 b ) for various HA/steroid formulations.
  • FIGS. 3 a and 3 b show the relative % of steroid recovery after heat treatment of various formulations.
  • One embodiment of the invention combines: a) a cross linked HA-gel; b) a modified or unmodified HA fluid and c) the insoluble steroid triamcinolone hexacetonide (TAH).
  • TAA insoluble steroid triamcinolone hexacetonide
  • HA cross linking Various procedures for HA cross linking are known, for example divinyl sulfone cross-linked HA as described in US2005 0142152, U.S. Pat. No. 5,143,724 and U.S. Pat. No. 4,582,865, each of which is hereby incorporated by reference.
  • Other suitable cross linking agents may be used in place of DVS.
  • formaldehyde, glutaraldehyde, glyoxal (U.S. Pat. No.
  • Formulations according to the invention are stable to an autoclave sterilization process. Additionally, the formulations are stable when subjected to accelerated stability tests such as a simulated two-year room temperature storage condition. Stability (as determined by rheology) of triamcinolone hexacetonide/viscosupplement combinational formulations compare favorably with formulations that replace the triamcinolone hexacetonide with a very similar steroid, triamcinolone acetonide (TAA). These two steroids are very similar chemically and a significant difference in stability would not be predicted.
  • TAA triamcinolone acetonide
  • Viscosupplements containing triamcinolone hexacetonide generally exhibited stability comparable to a viscosupplement control (the same formulation with no steroid) within the limits described.
  • Other steroid/viscosupplement combinations we tested demonstrated a decrease in HA stability as determined by rheology.
  • TAH formulations behaved comparably to control formulations having no steroid.
  • Other steroid formulations we tested either: a) (in the case of triamcinolone acetonide, methyl prednisolone acetate, and betamethasone phosphate) exacerbated degradation of HARC properties after heat treatment, or b) (in the case of betamethasone acetate) interacted with HARC.
  • the change in elastic modulus for different HA viscosupplement/steroid formulations are plotted in FIGS. 2 a & 2 b . Based on these experiments, we conclude that the TAH/HARC composition generally maintains a suitable level of stability when compared to the non-steroidal control.
  • FIGS. 3 a and 3 b The relative % of steroid recovery for all steroid/viscosupplement formulations is shown in FIGS. 3 a and 3 b . It is unexpected the triamcinolone hexacetonide/viscosupplement combinational formulations are stable while the triamcinolone acetonide/viscosupplement formulations are not stable based on the rheology evaluation. These two steroids are very similar chemically and large difference in stability would not be predicted.
  • composition will be a homogeneous colloidal suspension of triamcinolone hexacetonide, USP combined with an HA-based viscosupplement.
  • the physical appearance will be a milky white viscous fluid.
  • Product will be supplied sterile in a prefilled syringe (e.g, 5 mL with a 5 mL product fill).
  • Gen-S 1023-75 is a mixture of TAH (Triamcinolone Hexacetonide) with a HA based viscosupplement.
  • the viscosupplement was made with DVS modified HA gel (AVS-gel) and unmodified HA fluid at 65:35 ratio of gel:fluid.
  • Gen-S 1023-75 contained about 8 mg/ml TAH (lot#2196), 0.35 mg/ml Tween-80 (Lot#E35595), 6.5 mg/ml of HA/DVS gel (lot#EX0848) and 3.5 mg/ml of unmodified HA.
  • Gen-S. Rheological Properties ⁇ (5) St. G′(5) St. ⁇ (1) St. (°) Dev (Pa) Dev (Pas) Dev Specification Sample ID ⁇ 35° 20-150 Pa 30-100 Pas Gen-S 1023-75 21 0.7 86 2.8 70 8.5 (post-autoc) Gen-S 1023-75 34 2.1 36 3.5 43 3.5 24 hrs @ 80° C. Gen-S 1023-75 16 0.0 108 1.4 81 4.2 (pre-autoc)

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Dermatology (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Engineering & Computer Science (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Inorganic Chemistry (AREA)
  • Rheumatology (AREA)
  • Molecular Biology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Pain & Pain Management (AREA)
  • Immunology (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicinal Preparation (AREA)
US12/556,869 2009-09-10 2009-09-10 Stable hyaluronan/steroid formulation Active 2030-09-08 US8273725B2 (en)

Priority Applications (11)

Application Number Priority Date Filing Date Title
US12/556,869 US8273725B2 (en) 2009-09-10 2009-09-10 Stable hyaluronan/steroid formulation
EP10815804.9A EP2475251B1 (en) 2009-09-10 2010-08-10 Stable hyaluronan/steroid formulation
BR112012005423-6A BR112012005423B1 (pt) 2009-09-10 2010-08-10 Composição farmacêutica compreendendo um componente relacionado a ácido hialurônico, seringa e método para sua fabricação
EP19186507.0A EP3622820A1 (en) 2009-09-10 2010-08-10 Stable hyaluronan/steroid formulation
PCT/US2010/044975 WO2011031402A1 (en) 2009-09-10 2010-08-10 Stable hyaluronan/steroid formulation
CN201080043915.0A CN102573468B (zh) 2009-09-10 2010-08-10 稳定的透明质烷/类固醇制剂
JP2012528801A JP6121717B2 (ja) 2009-09-10 2010-08-10 安定なヒアルロナン／ステロイド配合物
MX2012002830A MX2012002830A (es) 2009-09-10 2010-08-10 Formulacion estable de hialuronano/esteroide.
ARP100103295A AR078281A1 (es) 2009-09-10 2010-09-08 Formulacion estable de hialuronano / esteroide
US13/593,026 US8680073B2 (en) 2009-09-10 2012-08-23 Stable hyaluronan/steroid formulation
JP2015138590A JP2015172095A (ja) 2009-09-10 2015-07-10 安定なヒアルロナン／ステロイド配合物

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US8273725B2 true US8273725B2 (en) 2012-09-25

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US13/593,026 Active US8680073B2 (en) 2009-09-10 2012-08-23 Stable hyaluronan/steroid formulation

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US (2) US8273725B2 (pt)
EP (2) EP3622820A1 (pt)
JP (2) JP6121717B2 (pt)
CN (1) CN102573468B (pt)
AR (1) AR078281A1 (pt)
BR (1) BR112012005423B1 (pt)
MX (1) MX2012002830A (pt)
WO (1) WO2011031402A1 (pt)

Cited By (2)

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Publication number Priority date Publication date Assignee Title
US8790702B2 (en) 2009-07-30 2014-07-29 Carbylan Therapeutics, Inc. Modified hyaluronic acid polymer compositions and related methods
US11541075B2 (en) 2005-12-14 2023-01-03 Anika Therapeutics, Inc. Treatment of arthritis and other musculoskeletal disorders with crosslinked hyaluronic acid

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PT2699274E (pt) 2011-04-20 2015-06-23 Carbylan Therapeutics Inc Composições formadoras de gel in situ
TWI424007B (zh) 2011-12-22 2014-01-21 Ind Tech Res Inst 使膠體交聯的方法與藉由此方法形成之經交聯的膠體
EP2943531A1 (en) * 2013-01-11 2015-11-18 Carbylan Therapeutics, Inc. Stabilized compositions comprising hyaluronic acid
IT201600075246A1 (it) * 2016-07-19 2018-01-19 Jointherapeutics S R L Composizioni comprendenti una matrice polisaccaridica per il rilascio controllato di principi attivi.
CN106983733A (zh) * 2017-03-08 2017-07-28 江苏富泽药业有限公司 曲安奈德plga缓释微球注射剂、其制备方法及其在制备治疗骨关节炎疼痛药物中的应用
KR20190038368A (ko) 2017-09-29 2019-04-08 주식회사 엘지화학 히알루론산 기반 하이드로겔 약제학적 안정화 조성물 및 그 제조방법
CN118021719A (zh) * 2022-11-11 2024-05-14 北京华视诺维医疗科技有限公司 一种曲安奈德组合物及其制备方法

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